Provider Demographics
NPI:1942676283
Name:TD PODIATRY PC
Entity Type:Organization
Organization Name:TD PODIATRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TAMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:DANILOV
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:917-589-0236
Mailing Address - Street 1:70 LITTLE WEST ST
Mailing Address - Street 2:SUIT #24C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10004-7410
Mailing Address - Country:US
Mailing Address - Phone:917-598-4300
Mailing Address - Fax:
Practice Address - Street 1:150 DELANCEY ST
Practice Address - Street 2:SUIT A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-3308
Practice Address - Country:US
Practice Address - Phone:212-598-4300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-20
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN006701213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty